Synthetic opioids are an escalating tragedy, but treatment for addicts doesn’t have to be a dead end

Fentanyl is the unbelievably potent opioid drug cited in the deaths of such stars as Michael Jackson, Tom Petty and Prince. Far from mansions and flash hotels, it is also the street-level heroin substitute that is at the centre of mind-boggling statistics for drug deaths across the US: about 64,000 people died from overdoses in 2016, up 21% on the previous year. Fentanyl is so toxic that even inhaling small particles can be dangerous, but for the amoral people selling it to the addicts who often use it intravenously, it has no end of advantages, starting with basic economics: whereas a kilo of heroin is said to cost $6,000 (£4,300) to produce and will sell for a few hundred thousand dollars, the respective figures for fentanyl are put at $4,000, and as much as $1.6m.

Inevitably, it is now coming to Britain. Last summer the National Crime Agency said that fentanyl had been cited in 60 deaths over the previous eight months, the majority of which had taken place in Yorkshire and the Humber. In Hull, where as many as 16 people are said to have died recently because of fentanyl overdoses, journalists found people who had been long-term heroin users who were sold batches cut with this new drug – which seemed to inspire a mixture of awe and fear. What they said was vivid, and frightening: “On a scale of one to 10, heroin is a two and fentanyl is an 11,”; “It just comatoses you and throws you to the floor”. Fentanyl and its derivatives have also been mentioned in reports from south London, Hertfordshire, Birmingham, Bristol and the Scottish borders.

In ‘fix rooms’ common in Europe, users take drugs using clean syringes, overseen by people who help them into treatment